Itraconazole cyclodextrin solution for fluconazole-refractory oropharyngeal candidiasis in AIDS: correlation of clinical response with in vitro susceptibility
Abstract
Objective To evaluate the efficacy of itraconazole cyclodextrin solution in fluconazole-refractory oropharyngeal candidiasis (OPC), and to correlate clinical outcome with in vitro susceptibility and serum azole levels. Design A prospective, open-label, intervention study. Setting A university hospital, which serves as the provincial HIV referral center. Patients and interventions Thirty six HIV-infected individuals referred for fluconazole-refractory OPC were evaluated prospectively between May 1993 and March 1995, including clinical assessment, serum azole levels, and susceptibility testing of Candida spp, isolates. Itraconazole solution was administered orally at a daily dose of 200 mg for 14 days, followed by suppressive therapy. Thirty-four patients were evaluable. Main outcome measure Resolution of oral pseudomembranous lesions. Results Initial isolates were Candida albicans (n = 33), C. glabrata (n = 1), C. krusei (n = 1), and mixed infection with C. albicans and C. krusei (n = 1). Fluconazole serum levels obtained at the time of failed therapy ranged from 4.7 to 40 mg/l (median, 12.9 mg/l). Itraconazole was generally well tolerated. Clinical responses were observed in 65% (22 out of 34) of evaluable cases. Among the responders, relapse had occurred within 2 months for four (36%) out of 11 cases who continued with follow-up. The median fluconazole minimal inhibitory concentration (MIC) was 64 mg/l for isolates from fluconazole-refractory cases, compared with a median of…
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Between 64% and 80% of patients with fluconazole-refractory oropharyngeal candidiasis respond to itraconazole solution.
“Between 64% and 80% of patients with fluconazole-refractory infections will respond to treatment with itraconazole solution [268][269][270].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [268]
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“Fluconazole-refractory infections should be treated initially with itraconazole solution; between 64% and 80% of patients will respond to this therapy [546, 547].”
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- Authors
- Phillips, P., Zemcov, J., Mahmood, W., Montaner, J. S. G., Craib, K., & Clarke, A. M.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Phillips, Peter
- Mahmood, Wafeeq
- Montaner, Julio S.G.
- Craib, Kevin
- ORCID
- Phillips, Peter
- Venue
- AIDS
- Published
- 1996-10
- Volume
- 10
- Issue
- 12
- Pages
- 1369-1376
- ISSN
- 0269-9370 (ISSN-L)
- OpenAlex
- W2002155710
- Cited by
- 88
- References
- 0
- Citations by year
- 2024: 2 · 2021: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- AIDS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV/AIDS oral health manifestations
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Keywords
- oropharyngeal candidiasis, HIV infection, Candida albicans, Candida glabrata, Candida krusei, antifungal susceptibility, clinical response
- MeSH terms
- Adult, Candidiasis, Oral, Cyclodextrins, Drug Resistance, Microbial, Female, Humans, Male, Middle Aged, Oropharynx, Prospective Studies, Solutions, Fluconazole, AIDS-Related Opportunistic Infections, Itraconazole
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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